Premature partial closure and other deformities of the growth plate: MR imaging and three-dimensional modeling

To examine growth plates of the distal femur and tibia with magnetic resonance (MR) imaging to detect bone bridges and other deformities in children.

Thirteen children (nine boys and four girls, aged 5-13 years; mean age, 9.8 years) were referred because of suspected or known bone bridging of the growth plate. Among the 13 patients, 10 had Salter-Harris fractures of the knee or ankle, two had Blount disease, and one had neonatal sepsis. Fat-saturated spoiled gradient-recalled images enabled reconstruction of a three-dimensional model of the growth plate. Patients underwent one to four MR examinations.

Nine patients had bone bridging of less than 1% to 39% of the area of the growth plate. On MR images obtained in the growth plate of five patients, a stripe of low signal intensity indicated fracture. On MR images obtained in three patients, intrusions of growth plate cartilage into the metaphysis were seen to increase in depth over time. MR images obtained in four patients showed no bridges. In the two patients who underwent surgery, excellent correspondence was found between MR findings and surgical observations.

Marked undulation or splitting of the growth plate may occur with fixation of some cartilage in the metaphysis or epiphysis while growth continues. The configuration of the growth plate and bone bridges can be accurately mapped with MR imaging. Treatment planning is facilitated.